HomeMy WebLinkAboutWORK ACCEPTANCE FORM JUDCO - 21-00160 - 1354 Clover Ct - New SFRContractor Work Acceptance Form
Business Name:*
Contact Name:*
Mailing Address
Email:*Phone:*
Mobile:
Discipline:*License #:*Expiration Date:*Value of Work:
Permit Number:*
Project Name:*
Project Address:*
By signing, I acknowle dge that I am the indicate d contractor for the abov e me ntione d Pe rmit/Proje ct.
Signature Date
Contractor/Subcontractor
Judco, Inc.
Misty Crain
City
St. Anthony
State / Province / Region
ID
Postal / Zip Code
83445
Country
United States
Update new contact information that is not already on file with the City of Rexburg
Street Address
2453 E 400 N
Address Line 2
mcjudco@gmail.com 2086241461
208-313-6247
Mechanical (HVAC)014820 4/20/2022 $
Permit Information
Please enter in the following format: 00-00000
21-00160 RX-01354 Clover
1354 Clover Court, Rexburg, ID
Acceptance
Sign 5/25/2021